Historically the only options for defeating obesity were drastic changes in lifestyle and some types of short-term medications that were not very effective or safe. When these methods failed, the only treatment known to be effective was some type of bariatric surgery like a gastric bypass.
Unfortunately, many individuals do not qualify for gastric bypass surgery or do not wish to undergo a surgical procedure for various reasons (anxiety, fear, recovery time, lack of support system, etc).
This creates a dilemma for individuals who may have been instructed by a doctor to lose weight because of critical health concerns. Today we will look at gastric bypass surgery, qualification requirements, how it works for weight loss, and available alternatives to gastric bypass surgery.
What Is Gastric Bypass Surgery?
Roux-en-Y gastric bypass surgery or more commonly called gastric bypass surgery is used to help treat obesity in cases when diet and exercise have not been effective.
During this two-step surgery, the patient’s stomach size is altered through a technique called vertical sleeve gastrectomy (VSG) or Laparoscopic sleeve gastrectomy (LSG) and most commonly known as gastric sleeve surgery. Gastric sleeve surgery is also performed as a stand-alone procedure but is the first part of gastric bypass surgery.
The surgeon cuts and removes about 75% of the patient’s stomach and closes the edges with staples leaving it the size of a small sleeve-like tube. The second step of gastric bypass surgery involves re-routing a portion of the small intestine so that the newly reduced stomach empties into the small intestine much further into the digestive process, bypassing a large portion of the small intestine.
How Does Gastric Bypass Help Patients Lose Weight?
Gastric bypass helps patients lose weight in two ways. First, it limits the amount of food the patient can consume in one sitting because of the reduced stomach size. This is known as a restrictive technique.
Next, due to the changes made to the digestive system, the calories that are consumed do not stay in the digestive system long enough for them to be fully absorbed. This is called the malabsorption technique. Gastric bypass helps patients with weight loss because it combines both restrictive and malabsorptive techniques.
Who Is A Candidate for Gastric Bypass Surgery?
Patients who qualify for gastric bypass surgery have a body mass index (BMI) of 40 or more, are 100 pounds overweight, or have a BMI of 35+, and also suffer from conditions that are driven by their obesity such as type 2 diabetes.
The bariatric surgeon may have other requirements patients must meet to be a viable candidate. Malnutrition can be a side effect of gastric bypass surgery so many doctors have their own criteria to screen patients before agreeing to perform this procedure. They want to ensure the patient is committed to the lifelong dietary requirements and lifestyle modifications necessary to succeed in healthy weight loss.
In addition to the basic and doctor-required qualifications for gastric bypass surgery, health insurance companies also have their own list of prerequisites which often require excessive documentation. The process for preauthorization for gastric bypass surgery can take months to navigate through and may not result in approval.
Are There Weight Loss Alternatives To Gastric Bypass Surgery?
There are both surgical and non-surgical alternatives to gastric bypass surgery.
Surgical Alternatives To Gastric Bypass Surgery
Surgical alternatives would be other types of bariatric surgery such as the gastric sleeve and the duodenal switch. If bariatric surgery was classified as small, medium, or large, gastric bypass surgery would be the “medium”. While it is both restrictive and malabsorptive, it is midway between the gastric sleeve which is restrictive only, and the duodenal switch which uses both techniques but the malabsorptive portion is much greater than that of the gastric bypass.
Patients who are not suitable candidates for gastric bypass surgery may also not qualify for these other surgical procedures. This is where the advancements in medicine and endoscopic techniques come into play.
What Are The Benefits Of The Non-surgical Alternatives To Gastric Bypass Surgery?
Non-surgical weight loss procedures are excellent alternatives to gastric bypass surgery and offer many benefits including a much less-involved qualification process. Other benefits include:
- Endoscopic procedures are less expensive than surgery;
- The recovery is usually only a week to ten days;
- Has a low-risk profile, and fewer associated complications (<1%);
- Temporary or can be reversed;
- The digestive system is left intact and no permanent changes are made;
- Patients are fully supported through these programs which assist with new behavior adoption and long-term success.
Non-Surgical Alternatives To Gastric Bypass
Unlike bariatric surgery, these alternatives reduce the patient’s stomach capacity to effectively treat obesity through an endoscopic procedure. An endoscope is a small flexible tube-like instrument that contains a tiny camera and a light that is lowered down the patient’s throat to access the stomach.
These are done as outpatient procedures and patients return home the same day to begin their short recovery. These less-invasive procedures have fewer risks and complications so patients are able to quickly begin making the necessary lifestyle changes that promote weight loss.
Prescription medication can be used as part of an endoscopic weight loss program to promote faster and greater losses.
1. The Orbera® Intragastric Balloon
A gastric balloon is a temporary medical device that is placed in a patient’s stomach to help promote weight loss. This gastric bypass alternative can assist individuals who have a body mass index of 25 or more to effectively lose weight safely. The Orbera balloon is used as part of a medically-supervised program that includes at least 12 months of comprehensive support.
Orbera Balloon Insertion Walkthrough
In this video, I walk through an Orbera balloon insertion! Not only is the procedure done within minutes, but you're also ready to leave soon after!
The balloon remains in the stomach for 6 months, significantly reducing its capacity and allowing the patient to only eat a small amount of food at a time. The patient’s stomach will also empty at a slower rate so they will feel satisfied longer. Reducing hunger pangs and forcing portion control for these six months is a useful tool and helps promote weight loss as the patient forms new healthier habits that include diet and exercise.
After the balloon is removed, patients continue to be monitored and supported for an additional six months. Professional support may include dietary specialists, nutritional guidance, exercise coaching, emotional counseling, etc.
Most patients experience significant weight loss during the first three months after the balloon is placed. Continued weight loss will occur as long as patients continue to practice their new healthy eating habits and incorporate daily exercise.
2. Suture Sculpt Endoscopic Sleeve Gastroplasty (ESG)
ESG is a procedure that is done to reshape a patient’s stomach into a smaller sleeve-like pouch and secure it together with sutures. There are no incisions and it is performed as an outpatient procedure. Since it is not a surgical procedure, the recovery is fairly short and patients can resume their lives much more quickly.
ESG is an excellent weight loss alternative to gastric bypass because it can deliver significant results without surgery. Gastric bypass surgery results in an average weight loss of 51-60% and ESG averages around 49%.
Studies have reported the effectiveness of this non-surgical alternative to gastric bypass surgery and endoscopic sleeve gastroplasty has recently been approved by the FDA.
The Suture Sculpt ESG procedure reduces the patient’s stomach by about 75% which limits the amount of food that can be eaten during one meal. The reduced stomach size also keeps patients feeling full longer because the stomach empties more slowly.
Endoscopic sleeve gastroplasty is an alternative to gastric bypass surgery for those patients who would not qualify for bariatric surgery. Since the procedure only takes about 45 minutes to perform it is also a safer procedure for those patients who have health issues that disqualify them for surgery.
How Do I Choose The Best Gastric Bypass Alternative?
Determining the best non-surgical weight loss alternative for you is to consult with an obesity specialist who understands the wide range of metabolic and other factors that promote or hinder weight loss efforts. This expert will help tailor a program that will be the most effective for your circumstances using some of the following factors:
- Current BMI;
- Medical history including intestinal issues;
- Ability and willingness to adhere to dietary guidelines;
- Probability of digestive complications;
- Other weight-related conditions.
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to see the entire table
|Gastric Bypass Surgery||Orbera Balloon||ESG|
|Type of Procedure||Surgical||Non-Surgical||Non-Surgical|
|Hospital Stay||1-3 Days||None||None|
|Recovery||6 weeks||3 days to 1 week||1 week|
|Procedure Length||1.5-2 hours||<30 minutes||45 minutes|
|Average Weight Loss Potential*||51-60%||30%||49%|
|Changes made to the stomach/digestive system||Permanent Alterations to the stomach and digestive system||Temporary weight loss tool||Reversible if necessary. No intestinal rerouting of the digestive system|
*Represents average weight loss during studies and trials. Many patients have surpassed these numbers.
If you desire to lose weight or have been advised by a doctor that your weight is affecting your health, you have non-surgical alternatives to bariatric surgery.
Dr. Steven Batash, one of the world’s leading experts on non-surgical options for weight loss, and the team at Batash Endoscopic Weight Loss Center are here to help you lose weight and keep it off. Located conveniently in New York City, The Batash team is committed to finding the best solution for your circumstances and then supporting you through your entire journey to reach your goals.
Set up a consultation today to learn about non-surgical alternatives to gastric bypass and other surgical weight loss procedures. Contact us today to learn more about these quick procedures that offer a quick recovery and a lifetime of healthy benefits!